Water Intake is important & Urine Output is important!
It is very important that dogs with Cystinuria are encouraged to drink plenty of fresh water throughout the day and night, and offered the opportunity to urinate often. In addition to always providing fresh water to drink, it is also a good idea to encourage them to drink it by changing the water several times throughout the day, running the hose, providing frozen treats, and adding water to the dog’s food.
The goal of drinking lots of water is to dilute the urine, which can help prevent the cystine from forming crystals or stones and helps the cystine flush out of the urinary tract. It is extremely important that you watch the dog to make sure it is able to urinate and bring it to your Veterinarian if you notice any problems or the dog does not have a steady flow of urine…
PLEASE Do NOT Let Your Dog Become Dehydrated!
Make sure your cystinuric dogs do not become dehydrated as that will cause the urine to become concentrated which can contribute to cystine stone formation.
Diet, Supplements and Urinary pH Levels
Please check with your Veterinarian before giving your dogs any vitamins or dietary supplements, especially if they have a medical condition such as Cystinuria. Some of the commonly used dietary supplements are extremely high in protein and/or amino acids such as methionine and cystine. These may cause elevated levels of cystine in the cystinuric dog’s urine and may cause the urine to become acidic which can possibly lead to stone formation. So please, watch what you are feeding your Cystinuria positive Mastiffs and also avoid adding salt to the food as that may also contribute to stone formation. The diet theories have not been proven and we encourage everyone to participate in Dr. Giger’s Diet Study to better understand the influences of diet and the expression of the disease.
Your Veterinarian may ask you to use pH strips to monitor your cystinuric dog’s urinary pH levels to make sure it is not acidic. If you are watching the urine’s pH level please do so under your Veterinarian’s supervision and direction. While trying to avoid acidic urine, you also need to make sure the urine pH does not get too high and become too alkaline as that can cause other problems such as encourage bacterial growth and other types of urinary stones to form.
Supplementing with acidifiers such as vitamin C or cranberry juice can decrease the pH level of the urine, which again can encourage stone formation in Cystinuria positive Mastiffs. You can check with your Veterinarian about supplementing with Ester C instead of regular Vitamin C as Ester C is advertised as being pH neutral or the same as distilled water which if true, should not cause the urine to become acidic but please follow the advice of your Veterinarian.
Avoid Stressful Situations
Although there is no proven relationship between stress and stone formation, some owners have noticed that their cystinuric Mastiffs that have formed stones have done so while experiencing high levels of stress, such as being around a bitch in heat or becoming over-heated or dehydrated. There is a lot of literature available on stress and the negative influences it can cause on our autoimmune systems and the body’s healing process. As in humans, some people believe our dogs also need to avoid stress when possible, especially if they have a compromised immune system or a potentially serious medical condition.
Medications and Surgical Procedures to Remove Stones
Medications may be prescribed by your Veterinarian to help treat Cystinuria. It has been reported that Thiola (Tiopronin) has been used very successfully, but it is expensive and costs several hundred dollars a month to treat a Mastiff. Penicillamine also known as Cupramine is a less expensive drug compared to Thiola, but some of the literature lists more side effects associated with it.
When dogs become blocked by urinary stones it is an emergency situation and they need to be seen by a Veterinarian right away. The Veterinarian may try to flush the stones back up the urethra and into the bladder which, when successful, can relieve the pressure and allow the dog to urinate. If the stones are large they may need to be surgically removed and often the Veterinarian will recommend a scrotal urethrostomy surgery to reroute the urethra, which may help the dog pass small cystine calculi when it is urinating.
The scrotal urethrostomy surgery has been very successful for many cystinuric Mastiffs, but there is often a lot of blood loss during recovery and the dog needs to be monitored to make sure it does not become anemic. It is also very important that the owner continues to monitor the urine flow of the dog to make sure it can continue to urinate without any problems as sometimes scar tissue can build up and block the urethra again. It is also common for the Mastiff to be neutered at the same time of the scrotal urethrostomy surgery.
Each individual Cystinuria positive Mastiff may express the symptoms of the disease differently and many will never show any symptoms at all. The same is true with how the individual dogs will respond to diet and medications and how well they will handle a specific medical procedure or major surgery. It is extremely important that you work closely with your own Veterinarian to determine what the best treatment options are for your dogs.